Immensely contagious Coronavirus disease was imported in Pakistan and became health emergency concern in no time. Pakistan, being a resource limited nation has encountered worst transmission dynamics and received public, social, economic challenges. Pakistani officials responded sufficiently to outbreak. However, community transmission became an emergent threat and proportion of mortalities became exponential.  Hence, Pakistan was scantily prepared to respond to an overhanging hazardous outbreak. This study comment on response of Pakistani government to Coronavirus disease, sheds light on challenges faced during the Covid-19 pandemic and concluded by highlighting concept of preparedness and providing some recommendations.

Introduction: An outbreak of pneumonia was observed in December, 2019 China which was named as Covid-19 (Corona virus disease 19) by WHO. The first case of Covid-19 appeared in Pakistan on Feb 26, 2020. Pakistan has responded well to the cause and had taken timely decisions. During Covid-19 depression, anxiety, sleep disturbances have been revealed among population of various countries. This study was carried out to determine the mental health status of general population in Karachi during Covid-19 pandemic. Materials and Methods: This was a web survey based cross sectional study. The data was collected through a self-administrated questionnaire which was developed on Google forms. The questionnaire collected information regarding participants demographics, their knowledge about Covid-19, their attitude and practices towards it and the last part was used to assess psychological impact and mental health status of the participants using IES-R (Impact of event revised) score and DASS-21 (Depression, anxiety and stress score). Multivariate analysis of variance (MANOVA) and independent t-test were used as tests of significance. Results: Majority 229(76.3%) of the participants were aged between 15-25 years. Social media was the main medium through which people 124(41.3%) learned about Covid-19. Evaluation of knowledge regarding Covid-19 infection showed that majority correctly knew about transmission sources and sign/symptoms of Covid-19 infection. Analysis revealed that majority of the people 167(55.7%) had normal depression subscale score (0-9), 196(65.3%) had anxiety scores within normal range and 198(66%) did not report stress and had normal scores. While assessing the psychological impact of Covid-19 we found that 221(73.7%) had normal IES-R score and had mild impact of Covid-19. Conclusion: Our study showed that people of Karachi were well aware about Covid-19. Majority of respondents did not report depression, anxiety, stress and serious impact of Covid-19 on their lives showing their optimism and great will to fight against the pandemic. Keywords: COVID-19, Psychological impact; Mental health.

Yellow coloured, i.e. xanthochromic cerebrospinal fluid,  with  hypercoagulability  and  high  protein  con- tent is pathognomic of Froin's syndrome. We present a  case  of  Froin's  syndrome  in  a  patient  with  spinal paraganglioma. A 55-year-old male patient presented with urinary hesitancy, numbness in lower limbs and difficulty in walking. During spinal anaesthesia, the anaesthetist  noticed  xanthochromic  spinal  fluid.  Upon  mag-  netic resonance imaging lumbosacral,  an  intradural  focal  lesion  of  abnormal  signal  intensity  extend-  ing from T12-L1 vertebral  level  was  seen.  Laminectomy  with  excision  of  the  mass  was  performed  and a fleshy encapsulated mass was excised. Histopathology report showed the specimen to be a neoplastic lesion, and immuno-histochemical studies confirmed the mass to be a paraganglioma. This case emphasizes that in  case  of  Froin's  syndrome,  one  should  think  of  spinal  cord  tumours  while evaluating the patient. A magnetic resonance imaging of the spine should also be done to look for spinal pathology along with other investigations.

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Introduction: University environment recognized as stressful and quiet often has a negative effect on student's life. Several studies indicate that there is an increased rate of mental health disorders like depression among university students around the world. There are many studies conducted to find the prevalence of depression among medical students in different cities of Pakistan. However, very few studies have been conducted to find the frequency of depression among non-medical undergraduate students of Karachi. Therefore we conducted this study to find the frequency of depression and its association with smoking habit among undergraduate students. Materials and methods: This was a cross-sectional study conducted on the male students studying at the University of Karachi. A selfadministered questionnaire having two parts was used to collect information from the participants. The first part was used to collect patients demographics and second part was used to assess depression. Data was analyzed using IBM SPSS V.20. Results:The frequency of depression among the study participants was found to be 80.5% (305). Among the study population 191(50.4%) were smokers and 188(49.6%) were non-smokers. Depression was observed in an overwhelming number of students who were smokers 168(87.9%). It was found that majority 229(60.4%) of the students did not had suicidal thoughts. Conclusion: Our study found a very high frequency of depression among university students. It also demonstrated an association between smoking and depression. We also found that the burden of smoking among students was significant.